Businesses need better handle on health care reform

There are a variety of issues keeping executives up at night, not the least of which is how health care reform is going to play out.

This was one of the significant takeaways from the Business Times’ latest survey of the region’s fastest-growing companies — the Pittsburgh 100.

The confusion and general unease about health care reform is justified. While the spotlight has been on Medicare since Mitt Romney tapped conservative budget hawk Paul Ryan to be his running mate, the nuts-and-bolts information business leaders crave about health care reform has gotten lost in all the mind-numbing political rhetoric and bitter campaign sniping.

Perhaps the October debates will finally produce a genuine discussion between the two parties on the relevant health care issues that matter to the real job creators. Perhaps not.

In an Aug. 21 health care reform panel discussion sponsored by the Business Times, UPMC Health Plan’s Sheryl Kashuba said rates could increase by as much as 40 percent if the Obama administration’s Affordable Care Act is fully implemented. Fueling the higher rates, she said, will be taxes on the insurance industry that will wipe out record recent-year gains.

The insurance industry reported a record margin of $16 billion in 2010, the year the Affordable Care Act was signed into law, but insurer taxes totaling $20 billion go into effect in 2014, when many of the law’s provisions kick in.

Up to 4 million small businesses are eligible for tax credits under the Affordable Care Act to help them provide insurance benefits to their workers. The first phase of the provision provides a credit worth up to 35 percent of the employer’s contribution. Small nonprofits may qualify for up to a 25 percent benefit.

Meanwhile, the Republicans support the private practice of medicine and oppose socialized medicine in the form of a government-run universal health care system. The party’s platform detours from the Affordable Care Act by “protecting citizens against any and all risky restructuring efforts that would complicate or ration health care; facilitate cooperation, not confrontation, among patients, providers, payers, and all stakeholders in the health care system; not put government between patients and their health care providers; not put the system on a path that empowers Washington bureaucrats at the expense of patients; not raise taxes instead of reducing health care costs; and not replace the current system with the staggering inefficiency, maddening irrationality, and uncontrollable costs of a government monopoly.”

What is clear in an otherwise muddled campaign is the differences between the two parties on health care are stark, and until there is a better understanding about how reform will impact businesses, anxiety and uncertainty will carry the day.